Perinatal Exposure to Tobacco and Respiratory and Allergy Symptoms in First Years of Life
Perinatal Exposure to Tobacco and Respiratory and Allergy Symptoms in First Years of Life
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DOI：
10.1016/j.arbres.2009.09.004
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发表时间：
2009-12-01
影响因子：
8
通讯作者：
Vall, Oriol
中科院分区：
文献类型：
--
作者：
Friguls, Bibiana;Garcia-Algar, Oscar;Vall, Oriol
背景和目的：分析产前和产后烟草暴露与4岁前呼吸道和过敏症状发展的关系。患者和方法：前瞻性和多中心队列研究，包括位于Ashford（英格兰），Barcelona和Minorca（西班牙）的AMICS（哮喘多中心婴儿队列研究）的受试者。我们招募了1611名儿童，从怀孕到4岁，他们的父母每年都会回答一份关于他们的烟草消费和孩子的呼吸和过敏健康状况的调查问卷。在巴塞罗那队列（n=487）中，在几个矩阵上分析了烟草暴露生物标志物（可替宁）。结果：产前烟草暴露与因呼吸道感染而住院的风险较大相关，特别是在生命的第二年，而产后烟草暴露与晚期喘息的存在和4岁时被诊断为哮喘的机会增加的相关性更强。产前和产后暴露的儿童有更多的持续性喘息，持续性鼻窦炎，早期咳嗽，每年上呼吸道感染的数量更高，被诊断为哮喘的人数更多。可替宁含量越高，发生喘息的风险就越高。没有发现烟草暴露与特应性症状之间的关系。结论：妊娠期和儿童期被动吸烟对儿童有明显的临床呼吸系统影响。因此，育龄妇女戒烟必须是预防医学的重点。(c) 2009年Elsevier Espana， S.L.出版，版权所有。
Background and objectives: To analyse the relationship between prenatal and postnatal tobacco exposure and the development of respiratory and allergy symptoms during the first 4 years of life.Patients and methods: Prospective and multicentred cohort study that included the subjects belonging to AMICS (Asthma multicentered Infant Cohort Study) located in Ashford (England), Barcelona and Minorca (Spain). We recruited 1611 children, followed from the pregnancy to the 4th year of life, whose parents annually answered a questionnaire on their tobacco consumption and their children's respiratory and allergy health. In the Barcelona cohort (n=487) a tobacco exposure biomarker (cotinine) was analysed on several matrices.Results: Prenatal tobacco exposure is associated with a greater risk of hospitalisation due to respiratory infection, particularly in the second year of life, whereas postnatal tobacco exposure is associated more strongly with the presence of late wheezing presence and increases in the chance of being diagnosed with asthma at 4 years of age. The children prenatally and postnatally exposed had more persistent wheezing, persistent rhoncus, early cough, a higher number of upper respiratory infections per year and a greater number were diagnosed with asthma. The higher the levels of cotinine measured, the higher was the risk for wheezing. No relationship was seen between tobacco exposure and atopic symptoms.Conclusions: Passive smoke exposure during pregnancy and childhood has very distinct clinical respiratory effects in children. Therefore, smoking cessation of childbearing age women must be a priority of preventive medicine. (C) 2009 SEPAR. Published by Elsevier Espana, S.L. All rights reserved.